Risk factors and cytokines for hospital-acquired infections in children with leukemia based on the propensity score matching method
OBJECTIVE To analyze the risk factors and cytokines for hospital-acquired infections in children with leukemia based on the propensity score matching method so as to provide data support for early identification of hospital-associated infection and control of infection in the leukemia children.METHOD A total of 1,695 children with leukemia hospitalized in the Pediatric Hematology Department of Wuhan Children's Hospital from Jan.2021 to Dec.2022 were selected as the research subjects,the differences in the covariates between the two groups were equalized by the 1∶1 propensity score matching(PSM)method,logistic regression analysis was used to summa-rize the risk factors for hospital-acquired infections in children with leukemia,and cytokine levels were compared between the two groups of children.RESULTS Hospital-acquired infections occurred in 104 children with leukemi-a,of which the site of infection was predominantly the blood system(51.92％),followed by the respiratory sys-tem(16.35％).104 pairs were successfully matched through PSM,and after matching,there was no significant difference in age,gender,length of hospital stay,and leukemia type between the two groups of patients.The hos-pitalization time(OR=41.650,95％CI:17.010-101.981),granulocyte deficiency time(OR=3.541,95％CI:1.489-8.425),induction chemotherapy period(OR=2.177,95％CI:1.190-3.984),surgery(OR=10.167,95％CI:2.223-46.464),and invasive procedures(OR=2.913,95％CI:1.585-5.353)were the risk factors for hospital-acquired infections in children with leukemia(P＜0.05).The hemoglobin(HGB)of the infection group was 81.66±13.80,which was lower than that of the no infection group,while the C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),and IL-10 of the infected group were(22.52±3.48)mg/L,(1.24±0.62)ng/ml,(373.64±129.62)pg/ml and(18.71±3.75)pg/ml,respectively,which were higher than those of the no infection group(P＜0.05).CONCLUSIONS PSM method reduced the selection bias in routine data collection studies and balanced between-group differences in baseline data.The induction phase of chemotherapy was a risk factor for hospital-acquired infections in children with leukemia,and targeted intervention measures should be taken during this stage to reduce the hospital-acquired infections.Early identification of hospital-acquired infections in children with leukemia could be enhanced through combined detection of HGB,PLT,IL-6,and IL-10.
万方数据
维普
